Edinburgh Tommys Centre

Tommys third research centre, at the Royal Infirmary of Edinburgh.

Introduction

The Edinburgh Tommy’s Centre for Maternal and Fetal Health opened in April 2008.

The Tommy’s Centre sits within the MRC for Centre for Reproductive Health and in the wider Queen’s Medical Research Institute in Edinburgh. In addition to those MRC CRH Principal Investigators whose activity is almost entirely focused on pregnancy research, (JEN, FD, and SS), those whose focus is gynaecology and early pregnancy (AH), and those who work on the molecular basis of reproduction and reproductive failure (NG) the Tommy’s Centre also includes those with primary appointments at the British Heart Foundation Centre for Cardiovascular Science in Edinburgh (BHF CCVS). These individuals (RR) bring a background in endocrinology and diabetes to bear on our primary foci of obesity in pregnancy and prematurity.

Research and clinical interests.

We work on the major clinical challenges of preterm birth, stillbirth, and the impacts of each of maternal obesity and maternal depression and stress. These are huge global issues - annually, preterm birth affects nearly 15 billion babies globally and 50,000 in the UK. Stillbirth rates in the UK are currently at around 1 per 200, rates which are commoner than most other European countries. Maternal obesity rates are now around 20%. The adverse impacts on pregnancy outcome include increased risk of caesarean section and stillbirth, together with an increase in minor pregnancy complications, all of which have a significant economic impact. Maternal stress and anxiety increases the risk of short term adverse outcomes including preterm birth and low birthweight and adverse long term outcomes for the offspring including abnormalities in glucose tolerance and cardiovascular response to stress.

Review of activity 2016 - 2017

The Tommy’s Centre continues to publish widely, with over 62 peer reviewed publications during this period.

Our ongoing grant funding in the field of pregnancy research is around £17 million. Funding from Tommy’s is key to almost everything we do, and certainly allows us to successfully apply for additional grants, such as those to conduct clinical trials including EMPOWaR, OPPTIMUM, GOT-IT, STOPPIT -2 QUIDs and AFFIRM.

Recruitment to STOPPIT 2 has passed the half way mark, and recruitment to GOT-IT and AFFIRM is complete. Recruitment to QUIDs is progressing well, QUIDs has been joined by QUIDS2, which began recruitment in September 2017.

Tommy’s staff also make major contributions to knowledge transfer. Jane Norman was also on the review group for the Scotland Maternity Services Review which was published in 2017. Fiona Denison Chairs of the RCOG Green-Top Guideline for Obesity and Pregnancy and is Vice-Chair of the NICE Medical Technology Advisory Committee. She also chairs the External Advisory Panel for a platform grant on advanced manufacturing for medical devices held by HW. Rebecca Reynolds is Chair of the Diabetes UK Clinical Studies Group ‘Causes of Diabetes’.

Major research achievements in 2016/17 include:

Jane Norman and Alex Heazell published the AFFIRM protocol in BMJ Open, and completed recruitment to the AFFIRM study

The OPPTIMUM study was a runner up in the 2016 BMJ “research paper of the year” award

Fiona Denison and Jane Norman published the GOT-IT protocol in BMJ Open and completed recruitment to the GOT-IT trial ahead of target. 1106 women with retained placenta were recruited from 28 sites across the UK.

Fiona Denison and Rebecca Reynolds published the clinical outcomes from the metabolic clinic. This showed that attendance at the metabolic clinic was associated with reduced rates of stillbirth and low birth weight and improved detection of gestational diabetes. (Denison et al., BMJ Open 2017 Jun 21;7(5):e015218.)

Major practice, policy and public engagement achievements include:

We ran an obesity in pregnancy study day. Over 100 people attended this and feedback was very positive.

Fiona Denison is leading development of the RCOG Green-top Guideline on Obesity and pregnancy with Rebecca Reynolds and colleagues.

Our paper describing improved outcomes for women attending the metabolic clinic was published in the BMJ Open. This received extensive national and international coverage. Fiona Denison was interviewed on Good Morning Scotland about the results.

Fiona Denison won the Medicity DEVELOP prize for customer discovery, the Medicity DEVELOP Engage Invest Exploit Prize, the Medicity DEVELOP runner-up Prize and the Converge Challenge KickStart Digital Entrepreneur Award for her pioneering “birth mirror”. She has been short-listed as a semi-finalist in Scottish EDGE 11.

Jane Norman was elected to the Royal Society of Edinburgh

Jane Norman was elected Honorary Fellow of the British Association of Perinatal Medicine

The University of Edinburgh

The University of Edinburgh is a charitable body, registered in Scotland, with registration number
SC005336, VAT Registration Number GB 592 9507 00, and is acknowledged by the UK authorities as a
“Recognised body” which has been
granted degree awarding powers.